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Who Is a Candidate for Bariatric Surgery?

Why weight loss surgery works when other solutions fail

A bariatric surgery candidate gets checked by her physician.

Why weight loss surgery works when other solutions fail

For many people, the best thing they can do to improve their overall health is lose weight. Even people who are only a few pounds over their ideal weight can benefit.

The health benefits from reaching a normal weight are amazing, particularly for those who are significantly overweight or obese. Weight-loss or bariatric surgery is an option in some cases when efforts to lose weight through diet and exercise are unsuccessful and other weight-related health issues are involved.

Who qualifies for bariatric surgery?

Having a body mass index (BMI) above 30 dramatically impacts both quality of life and health. A BMI between 35-50 is considered morbid obesity and above 50 is considered extreme obesity.

National Institute of Health guidelines state that patients with Class III obesity qualify for bariatric surgery. Class III obesity is defined as having a body mass index (BMI) greater than 40, or greater than 35 with an obesity-associated medical problem, such as diabetes, sleep apnea or high cholesterol.

“Many people who are overweight or obese spend years trying to take off the weight through diet and exercise, but have no success. In those cases, bariatric or weight-loss surgery can be life-extending,” says William Fuller, MD, a bariatric surgeon at Scripps Clinic Center for Weight Management and Bariatric Surgery in Del Mar.

What are the risks and benefits of bariatric surgery?

It’s important to note that a bariatric procedure is usually only considered after more conservative weight loss methods have failed. There are different types of bariatric surgeries, but they all involve dramatically reducing the portion sizes which patients can consume by altering gastrointestinal anatomy. Some of these procedures also dampen the hormonal signaling that encourages eating. For people with severe weight issues, this is a good outcome. Bariatric surgery is very safe, but there are still risks.

“It’s worth repeating that bariatric procedures are very serious surgeries that are usually only considered when other efforts have failed,” Dr. Fuller says. “Generally, the patient has severe obesity making them at risk for cardiovascular disease, diabetes or another serious condition. In those cases, the risks posed by the surgery are greatly outweighed by the risks of being obese.”

Getting ready for bariatric surgery

Preparing for bariatric surgery requires a lot of motivation and commitment.

“The whole point of bariatric surgery is to help patients change their eating habits. It’s critically important that they have the motivation to accomplish this,” Dr. Fuller says. “Continuing with the same diet could have disastrous health consequences.”

In addition, depression and other mental health conditions can lead to binge eating. So, for those looking into bariatric surgery, psychological status is an important consideration and being evaluated prior to surgery is wise.

“I cannot overstress the importance of being a motivated patient,” Dr. Fuller says.

“Weight loss surgery is not the easy way out. It requires a deep commitment to the process before, during and after the procedure," Dr. Fuller says. “For people who make that commitment, bariatric surgery can go a long way toward restoring good health."